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DSH510007P ST. MARYS MEDICAL CENTER INC. (Terminated)
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Main Details
Name
ST. MARYS MEDICAL CENTER INC.
Subdivision Name
St. Mary's Family Care - Highlawn
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH510007P
Medicare Provider Number
510007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/1/2019
Participating Start Date
1/1/2020
Participating Approval Date
10/3/2019
Last Recertification Date
8/26/2024
Termination Date
Termination Reason
4/1/2025
Site closure
Contacts
Authorizing Official
St. Mary's Medical Center
Aaron C Blevins, Chief Pharmacy Officer
(304) 526-8250
Primary Contact
St. Mary's Medical Center
Kathy Walker, 340B Program Coordinator
(304) 526-8748
Addresses
Street Address
2833 5th Ave
Huntington, WV 25702-1435
Billing Address
St Mary's Medical Center
2900 First Ave
Huntington, WV 25702-1241
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 4/1/2017; terminated 1/1/2018; Reinstated 1/1/2020.
10/03/2019
May 2025
May 2025
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